Depression, is it the way we think or our brain chemistry?

As a Psychologist working within the NHS, I have helped many people with depression over the years. In working psychotherapeutically with people I have largely used cognitive behavioural therapy, an approach that aims to help people think about events in more helpful ways and abandon an invariably pessimistic style of thinking in favour of a more balanced or even optimistic perspective.

Many of the people that I have worked with have also been taking antidepressants such as citalopram, sertraline. These SSRIs work by altering the levels of specific chemical messengers in the brain such as serotonin. Whilst we have been aware for many decades that people’s mood is affected by these chemical messengers there has been a good deal of uncertainty as to the reasons why.

How Cognitive Behavioural Therapy Works

We believe that cognitive behavioural therapy works by affecting the negative bias of people’s thought processes. For example, many studies have shown that depressed people are more sensitive and aware of sad faces than they are of faces with a happy or neutral expression.

Armed with this information we can help people to direct their attention more objectively and thus develop a different perspective about their environment and effectively correct for their clouded vision. A recent theory suggests that antidepressants may work in a similar way.

Effects of AntiDepressants

Dr Catherine Harmer, a neuroscientist at University of Oxford, has been gathering evidence that suggests that antidepressants may also work by altering negative emotional processing. About a decade ago she administered popular antidepressants to a group of healthy individuals and found that they positively altered their emotional perception. She also found more recently, 2009, that a single dose of a common antidepressant altered emotional processing in depressed patients within a matter of a few hours.

Prior to taking antidepressants depressed people showed less sensitivity to happy faces, remembered fewer positive words and took longer to respond to positive descriptors of themselves than healthy volunteers. After taking the antidepressants the responses returned all these measures to normal levels. Surprisingly this changes in emotional processing can take place very quickly, perhaps after even a single dose of antidepressant.

Depression Research Findings

Yet we know that people can often take several weeks before noticing any change to their mood. Harmer believes this delay may be attributable to the fact that people need some time to become acquainted with the world as seen through their new more positive perspective.

Harmer’s research is exciting in that it allows us to begin to unite biological and psychological perspectives on treating depression and ultimately this must be good for people who suffer with this condition.

If you have or are struggling with depression and feel that psychological therapy may be helpful you can contact me here.